The "Childmyths" blog is a spin-off of Jean Mercer's book "Thinking Critically About Child Development: Examining Myths & Misunderstandings"(Sage, 2015; third edition). The blog focuses on parsing mistaken beliefs that can influence people's decisions about childrearing-- for example, beliefs about day care, about punishment, about child psychotherapies, and about adoption.
See also http://thestudyofnonsense.blogspot.com

Concerned About Unconventional Mental Health Interventions?

Sunday, February 15, 2015

Mindfulness in Early Intervention, Sure; Tapping, No

The publication Zero
to Three makes a point of connecting science, policy, and practice related
to work with young children, and for several decades it has done a good job of
this. But occasionally somebody slips, either in writing or in the review
process, and something emerges that cannot be called science-based.

That has happened in an article in the January 2015 issue
(Shahmoon-Shanok, R., & Stevenson, H.C. [2015]. Calmness fosters
compassionate connections: Integrating mindfulness to support diverse parents,
their young children, and the providers who serve them. Zero to Three, 36(3), 18-30). The authors spend pages emphasizing
the role of mindfulness and calm in allowing us to be aware of the thoughts and
needs of other people—and no one can argue with the idea that a person who is
not calm is likely to misread others’ communications and behave in ways that
are mistaken and noncompassionate. An angry or fearful caregiver can do a very
poor job, especially with children whose communications are hard to understand.

But-- by page
25 it becomes clear that one of the authors has a curious take on mindfulness.
Not only does she connect awareness with EMDR (Eye Movement Desensitization and
Reprocessing), a form of psychotherapy based on an implausible theory and with weak
empirical support, but she favors the methods of one Laurel Parnell, author of Tapping in: A step-by-step guide to
activating your healing resources through bilateral stimulation. (Boulder, CO:
Sounds True [sic]). And yes, this
means actual physical tapping.

The Zero to
Three article advises using Parnell’s technique, and describes a situation
where an early intervention worker was having difficulty helping an
undocumented Mexican immigrant mother who complained a great deal (and had much
to complain about!). Her EI worker had been in the habit of asking the client
to give more and more information about each of her complaints. But, after
learning about Parnell’s technique, the EI worker instead asked the woman to
describe where she felt tension in her body and guided her to breathe deeply
and relax. The worker then asked for a description of a “safe place”—a time
when the mother had felt safe and optimistic. Following a description of being
in her grandmother’s lap, the EI worker guided the woman to remember sensations
and smells she associated with the sense of safety.

And here’s where the “tapping” comes in. “Once the
mother elaborated these sensory details, the worker said ‘Let’s tap this in’…,
alternating tapping her feet on the floor, or her hands on her thighs. The worker
smiled and said, ‘When you tap one side of your body and then the other, you
make this happy memory of your yaya even stronger. This is a good place to go
when you’re upset. She’s right there to help you calm down and feel better. You
can practice this coming week and when I come next time, we’ll practice some
more” (Shamoon-Shanok & Stevenson, 2015, p. 21).

Sounds harmless, even pleasant, doesn’t it? So why
am I concerned that this practice is being presented as scientifically
supported through publication in Zero to
Three? The first reason is simply that there is no scientific evidence that
these methods are effective. There have been lengthy arguments about EMDR, the
claimed source of the “tapping” technique, and these have concluded that to the
extent that EMDR is an effective treatment, it is so because it shares various
factors common to all effective psychotherapies, such as interaction with a
warm and supportive therapist or helper. The specific methods of EMDR-- eye movement and other forms of bilateral
stimulation-- are probably irrelevant to
the outcome of the treatment. Similarly, while it was comforting for the mother
described earlier to think of a pleasant and safe memory, and while this was a
positive experience which might help her stay calm and responsive to her
children, “tapping it in” had nothing to do with the outcome.

Telling either the mother or the EI worker that
bilateral tapping is magically helpful is not only untrue, but encourages them
to think about mental processes in inaccurate ways and thus opens them to
consideration of treatments that are potentially harmful in either direct or
indirect ways. In addition, the stress on tapping distracts people from using
evidence-based treatments that they may find more challenging than the simple ritual
they are offered. A persuasive analogy to computer programming is employed when
the EMDR language of “installation” is used.

Where does the tapping ritual come from? Parnell
references the writings of Francine Shapiro, originator of EMDR, and her claim
that when the body is bilaterally stimulated this experience hastens the “processing”
of negative thoughts and events. Shapiro apparently based this claim on her
experience when walking in the woods one day and moving her gaze back and forth
while brooding on an unhappy memory. After her walk, she felt better-- which she attributed not to the passage of
time or a pleasant walk, but to the fact that she had been moving her eyes back
and forth. Because she naturally had been using both eyes in a coordinated
fashion, she decided that it was the bilateral movement that did the trick.

Now, it’s nice that Shapiro felt better, but how
could she not have been experiencing
bilateral movement, during her walk or at almost any other time in her life? Except
for people who have lost an eye or have paralyzed eye muscles on one side, all
of us are coordinating our right and left gazes at all times, whether by
changing the direction of the gaze to one side or the other or by converging or
diverging the eyes as we look at nearer or more distant objects. Similarly, the
act of walking involves bilateral coordination, as one foot takes up the body
weight transferred from the foot that is taking a step. Simultaneously, the
shoulders and torso counter-rotate in order to maintain the body’s balance as a
foot is lifted; the counter-rotation in turn causes the arms to swing back and
forth in opposition to the legs’ movements. We are all doing this all the time,
so Shapiro’s and Parnell’s claims that
EMDR uses a specialized technique can hardly be supported.

The idea that bilateral activity is special and
magical seems to have derived from the claims of the alternative practitioners
Doman and Delcato in the 1960s. These people argued that the movement of
crawling involved bilateral action as walking did not (but see above), and that
this bilateral action provided sensory feedback that acted to “build” the
brain. Those who had brain-related disorders such as autism or cerebral palsy
must not have had enough bilateral movement, and they could be cured by being
forced to crawl, or subjected to “patterning” in which helpers moved the
patient’s head, legs, and arms in ways that imitated reflexive crawling movements
of very young infants. It has been well known for many years that these methods
are completely ineffective, but the appeal of bilateral stimulation persists
and the naïve are still easily sold on this idea.

Another book by Parnell, A therapist’s guide to EMDR (W.W.Norton), provides another insight
into the “tapping” approach. Parnell’s “tapping in” is clearly related to the
various energy therapies such as Thought Field Therapy and Emotional Freedom Technique,
where physically tapping at certain points on someone’s body and at certain
rates of speed are expected to free the individual from emotional distress.
This practice appears to be based on the idea that the human body has “meridians”--
lines that enable the flow of psychic energy or qi and which if blocked will cause unpleasant psychological
experiences. Tapping at a given rate of speed on a given meridian is claimed to
release qi to flow appropriately. In
spite of various efforts to test these claims, there is no evidence that energy
therapies employ tapping to good effect, and of course the theories behind that
use of tapping are implausible in terms of the accepted foundations of the
scientific study of psychology.

Of course it is tempting to say that if the mother
described earlier liked tapping, she should get to have it—until we question
whether public funds should be expended on ineffective treatments.. The mother
and her EI worker may well feel that if she feels better following her tapping
experience, her improvement must have been caused by that experience, and the
treatment should be not only allowed but encouraged. However, today’s standards
for how we spend scarce public resources are much more stringent than that, and
professionals on the whole turn to scientific evidence to help decide whether a
method is actually effective. I hope that in the future Zero to Three’s reviewers will also take that approach.

They seem to think that stimulating both sides of the body (bilateral stimulation) in any way has magic effects, and I think that would include binaural (both ears) stimulation. However, messages to the left ear are carried to both the left and the right sides of the cortex, and same for the right ear, so I'm not sure how binaural stimulation would be special, except that it allows us to tell which direction a sound is coming from.

I was shocked to look at the W.W. Norton site and see what junk they are listing. I suppose the thing is that publishing is a business, and they are bringing out what they think will sell. But it's a shame to see a respectable publishing house go in this direction.

The term qi, as used here, refers to "spiritual energy" which supposedly resides in the spine and needs to circulate freely. I think the term must have many meanings-- steam from rice is an interesting one, and you can see the analogy!

Yes, I probably would remember if I had done that kind of work! Maybe you're confused by the titles of some of my papers from way back when. They didn't involve infants, or effects on development, but they were about the temporary effect of some kinds of stimulation on specific perceptual abilities-- like being able to tell what is straight ahead of you, or being able to identify vertical or horizontal lines as they really are, rather than making the mistake of choosing one that is tilted just a tiny bit. These effects last only briefly and are apparent only when a person has very little else to look at or listen to.

To quote "The Color Purple": "it all just too triflin and confuse". It's gotten to the point where I get the creeps when I see the word "healing"-- it always seems to be associated with some cockamamie idea. Yet, I am finding it very difficult to get American Psychological Association members interested in the idea that we need to fight back actively.

When I was in therapy for a short time a few years ago, my therapist tried to do EMDR on me. It didn't seem to work, but it probably wasn't a fair test as I couldn't stop laughing when she was doing it!

About Me https://en.wikipedia.org/wiki/Jean_Mercer

Jean Mercer has a Ph.D in Psychology from Brandeis University, earned when that institution was 20 years old (you do the math). She is Professor Emerita of Psychology at Richard Stockton College, where for many years she taught developmental psychology, research methods, perception, and history of psychology. Since about 2000 her focus has been on potentially dangerous child psychotherapies, and she has published several related books and a number of articles in professional journals.
Her CV can be seen at http://childmyths.blogspot.com/2009/12/curriculum-vitae-jean.mercer-richard.html.